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KMID : 0378120030300020153
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Chungnam Medical Journal
2003 Volume.30 No. 2 p.153 ~ p.170
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Etoposide, Doxorubicine and Cisplatin(EAP) Combination Chemotherapy for Patients with Recurrent or Advanced Esophageal Carcinoma
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Park Su-Jin
Chun Jae-min
Park Nam-Sook
Kwak Seung-Keon
Park Sang-Eun
Kim Chul-Hee
Yun Hwan-Jung
Jo Deog-Yeon
Kim Sam-Yong
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Abstract
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The authors performed etoposide and cisplatin chemotherapy combined with doxorubicine for the patients with recurrent or advanced esophageal carcinoma to identify the efficacy and toxicity of the chemotherapy that is usually used in treatment for patients with gastric carcinoma.
The authors treated 17 consecutive patients who were newly diagnosed as advanced esophageal carcinoma with UICC stage Ⅲ/Ⅳ, or whose status of disease was recognized as recurrent with etoposide, 100mg/m^(2) on Day 4 to 6; doxorubicine, 20mg/m^(2), on Day 1 and 7; cisplatin, 40mg/m^(2) on Day 2 and 8(EAP-Ⅰ chemotherapy) every three weeks. Seven patients were also treated every 3 weeks with etoposide, 20mg/m^(2) on Day 1 to 5; doxorubicine, 20mg/m^(2) on Day 1 and 5; cisplatin, 20mg/m^(2) on Day 1 to 5(EAP-Ⅱ chemotherapy).
EAP-Ⅰ chemotherapy was performed for 47 cycles, and EAP-Ⅱ chemotherapy, for 17 cycles. Overall response rate was 25%, and patients showing complete response, partial response, stable disease, and progressive disease were 0case(0%), 6(25%), 4(17%), and 14(58%) respectively. There was no significant difference in response rates between patients treated with EAP-Ⅰ chemotherapy and those treated with EAP-Ⅱ chemotherapy, The survival duration in 24 patients was within a range of 11-48 weeks, and median value was 30 weeks. The survival duration in responders was 29-48 weeks, and its median value was 37 weeks. The response duration in non-responders was 11-42 weeks, and its median value was 28 weeks. There was a significant difference in thesurvival duration between responders and non-responders on the Kaplan-Meier survival curve. ECOG performance status and response to chemotherapy influenced the survival duration significantly among factors such as sex, age, ECOG performance status, severity of loss body weight, histologic subtype, history of treatments, and presence of responses. All patients were evaluated for toxicity. Grade 1-4 neutropenia occurred in 28 cycles(44%) of overall 64 cycle. Grade 3-4 neutropenia occurred in 12 cycles[9 cycle(l9%) in EAP-Ⅰ chemotherapy and 3 cycles(l8%) in EAP-Ⅱ chemotherapy]. Thrombocytopenia occurred in 23 cycles(36%). Grade 3-4 occurred in 9 cycles(14%)[7 cycle(l5%) in EAP-Ⅰ chemotherapy and 2 cycles(l2%) in EAP-Ⅱ chemotherapy]. There was no significant difference in hematologic toxicity between the two groups, Nausea and vomiting occurred in almost all patients. Grade 1 and 2 stomatitis occurred in 6 case(25%) and 2 cases(8%) respectively. Diarrhea occurred in 5 case(21%). Peripheral neurotoxicity occurred in 3 cases(l2%). Nephrotoxicity occurred in 7 cases(29%).
Even though etoposide and cisplatin combined with doxorubicine in patients with recurrent and advanced esophageal carcinoma is active, it is also associated with substantial toxicity.
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KEYWORD
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Esophageal cancer, EAP chemotherapy
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